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beandoctor, Pediatrician

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I read an article about children having bad dreams linked to

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I read an article about children having bad dreams linked to bedwetting. My child wets the bed sometimes and I'm wondering if it could be due to bad dreams some of the time? She has always been a bedwetting, it's not a new thing. She does good for a few weeks, then she has an accident.

I'm a pediatric nephrologist (kidney doctor) so I get to see plenty of kids who wet the bed... and I don't usually worry about bad dreams being the culprit. Unless there are other things that make you worry about your child's dreams, I can probably reassure you a little bit about that.

Most children who have always been bedwetters (but are dry during the day) are completely normal - just "late bloomers" for developing the neurological maturity to avoid wetting the bed. To hold your urine overnight requires that your brain and bladder talk to each other and hold the urge to void. Most children develop this by age 5, and about 10% of those who don't will gain that ability each year thereafter. So time is on your side!

However, if the bedwetting is occurring frequently enough that you don't want to wait, there are things we can do to help. We have medications that help to decrease the production of urine overnight (the most commonly used are imipramine and DDAVP), and those are helpful for many children. A bedwetting alarm program is even more successful, but makes a lot more work for you and your family. Your daughter's pediatrician could help get you started with either of those things - but of course I'd be happy to answer any questions in the meantime!

I hope that this information is useful to you... if I have answered your original question, please take a moment to rate the quality of my response. And if you have any more questions - now or in the future - please just ask!

What do you mean other things that make me worry about my child's dreams? Like sleepwalking and stuff?

Customer:replied 1 year ago.

She doesn't have bedwetting episodes all the time. Just randomly, but she has always had them since potty training. Like I stated she will go a few weeks, no accidents then the next week she might have one or two. The last two years it was all the time, but now that she's 5 it's just once in a while. So it has improved a lot! She has a daytime accident once in a while(hardly ever), but it's like if she waits too long to go to the bathroom she leaks a little bit....I'm assuming that happens at her age too?

At 5, having some night-time wetting on occasion is pretty normal. And particularly if it's getting better with time and not causing any big problems at home, I'd be inclined to give her some time to outgrow it.

However, the daytime accidents and leaking make me a little more concerned. Usually, once kids are toilet trained, they stay dry during the day. But there are lots of kids out there who don't like to stop what they're doing to use the bathroom, and end up "holding" their urine for too long. Over time, that disrupts the normal brain-bladder signals and leads to more accidents. (This is called dysfunctional voiding syndrome.)

If that sounds like your daughter at all, then I have two pieces of advice for you.

The first is to get her on a good bowel regimen. Any amount of constipation will work against you with the wetting accidents. There's a limited amount of space in everyone's pelvis, and that space has to accommodate both the bladder and the colon. If the colon is full of hard poop, it tends to push in on the bladder and disturb the normal sensations of fullness and communication with the brain.

The second is to get her on a timed voiding regimen. What I mean by that is that she should go to the restroom every 2-3 hours during the day - even if she doesn't feel like she has to go. If she's having leaking, it means her bladder is getting too full - so what we need to do is keep it more empty.

I hope that this helps - please let me know if you have more questions!

Yes, if she's having sleepwalking, or seems bothered by the dreams that she is having during the daytime, then maybe we should look into the bad dreams further. But if those aren't really concerns at this point, I don't think I'd worry about them on the basis of the bedwetting. Does that make sense?

She has had maybe two bad dreams in the last three months. So not a regular basis and she doesn't wake up but it usually has something to do with the tv show she watched the night before. For instance ahead watched the kids movie "hocus pocus" she said she had a bad dream the next day or so about witches (that's what the movie is about) so the dreams aren't so scary she's woken up...maybe it's just a coincidence that last time she had a Vader dream she wet the bed...how do you mean "look into the dreams further" like seeing if something's triggering it like maybe the movies or a tv show, and not let her watch them?

Customer:replied 1 year ago.

And you meant if the dreams are bothering her in the daytime...like if she can't forget the dream and she still scared of the dream throughout the day correct?

Yeah I read somewhere that 4 out of 5 children have a bad dream one a week and that they grow out of it with time. And just for curiosity sake...what would be a daytime issue if the dream scared them throughout the day...like maybe kids picking on or bullying them? Things like that?

Yes. The first thing I'd worry about is that the child was having some kind of trauma elsewhere in their life - bullying, abuse, etc.

If that didn't seem to be the case, I'd worry next that the child may have some trouble "moving on" from normal frightening things (for example, a child with severe anxiety or obsessive-compulsive disorder might get fixated on the scary things in their dreams to the point where they can't forget about them during the day).

Oh I get what your saying now....sorry when you said "when dreams still bother them in the daytime, it make you think there is a daytIme issue going on" ...i Was trying to figure out what you meant about a daytime issue....and you were meaning like something going on at maybe school like a bully, or a kid picking on or hitting them and that causing the nightmares and stuff...so they fear them in the day too. Correct?

I worry about bullies all the time...it is awful in schools now adays! But like I hers are always about something she's seen on tv or a scary story or something. And last reply I promise....the once in a while daytime leaking u said u were concern about...u think may be her holding it too long(because she waits till the last minute bc she's too busy playing or watching tv) and it's making the signal to the brain confused and her bladder is over filling? But that is a common ocurance with kids her age right?

Yes - I think you are exactly right. She's holding her urine too long, which leads to overfilling and the leakage type accidents. We don't want her to bladder to become too good at holding urine - or her brain to become too good at ignoring her bladder's signals that it's full. Instead, we want to keep her bladder decompressed, and get her used to emptying the bladder before it's overdistended. The best way to do that is with the timed voiding regimen that I mentioned before. It'll take some work - but I promise you'll be saving yourself lots of problems later!

So the daytime leaking once in a while concerned you bc if she continues to wait till the last minute and leaks some it's gonna cause bladder problems in the future because it's interrupting the bladder to brain function and the bladder Is becomIng overfIlled and may become permanent?

That's pretty much right... the only change I'd make is to say that although the problem wouldn't be permanent, it will become a lot harder to deal with the longer that it goes on. The botXXXXX XXXXXne is, the better your brain gets at ignoring your bladder signals, the harder it is to "unlearn" that bad habit. Your little girl sounds like she doesn't have a big problem at this point - but I do think we need to address it now so that it doesn't become one!

We started a schedule of every 2-3 hours this morning and I let the daycare know also! She is being treated for constipation too so I'm sure both those factors are playing into The enuresis. Thanks again!!

I will tell you that...the things you have to go through to be an Expert are quite rigorous.

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